The American College of Physicians is warning physicians about asking patients for donations.
In a Sept. 26 position paper, the authors cautioned physicians not to ask patients for donations to the clinician's workplace. In recent years, grateful patient fundraising has become more common in healthcare systems and requires physicians to solicit donations from current and former patients. The funds may be used for operating costs, clinical research, equipment upgrades or facility improvements.
However, the model can interfere with the physician-patient relationship, the ACP wrote. Once involved in fundraising, patients may also develop unrealistic expectations for the kind of care they receive. Patients may also feel pressured to contribute due to concerns of how their relationship with their physician may be altered if they do not.
Confidentiality and privacy concerns also could arise because HIPAA allows hospital fundraisers to access health information of patients who donate and electronic health records have been used as tools to aid fundraising efforts. Patients may be unaware of the hospital fundraising department's access to their records or that they have a right to opt out of fundraising efforts.
Some employment contracts require clinicians to ask patients for money or flag potential donors. These metrics or expectations create an ethical snare for clinicians, which can put them between their patient and employer, the ACP wrote.
"Physicians should not be asked or expected to participate in fundraising solicitation of their patients or patient families," the authors said. "Participation in fundraising should not be a condition of employment, nor should it be a performance metric or part of an incentive system for physicians."
The letter encourages physicians to direct patients and families interested in donating to speak directly with administrators.
"Philanthropic goals in healthcare can be pursued in various ways, but grateful patient fundraising by physicians is ethically problematic," the authors wrote. "In addition, patient expression of concern about this practice emphasizes the potential for erosion of patient and public trust in institutions and the profession — another red flag, and an intuition that should be heeded, lest this practice ultimately harm both patient care and ethically appropriate philanthropic efforts."